How much rates vary
Facilitymedian $1,230 · 10th to 90th $955 to $1,820Professionalmedian $1,549 · 10th to 90th $741 to $2,239
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $676.08 Median $831.76 Typical High $4,365.16 | Facility | None | $676.08 | $831.76 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $831.76 | Professional | None | $562.34 | $707.95 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,548.82 | Facility | None | $1,023.29 | $1,230.27 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,819.70 | $2,089.30 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,819.70 | Facility | None | $870.96 | $1,202.26 | $1,819.70 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $2,041.74 Typical High $6,165.95 | Professional | None | $741.31 | $2,041.74 | $6,165.95 |
Midlands Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,548.82 | $1,548.82 | $1,905.46 |
Midlands Setting Facility Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,819.70 | Facility | None | $1,023.29 | $1,096.48 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,412.54 | $1,412.54 | $1,698.24 |
Sanford Health Plan Setting Professional Modifier None Typical Low $831.76 Median $1,258.93 Typical High $1,621.81 | Professional | None | $831.76 | $1,258.93 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,819.70 | Facility | None | $1,513.56 | $1,513.56 | $1,819.70 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,380.38 Typical High $2,344.23 | Professional | None | $724.44 | $1,380.38 | $2,344.23 |
Wellmark Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,995.26 | Professional | None | $1,202.26 | $1,380.38 | $1,995.26 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $354.81 Typical High $457.09 | Professional | 52 · Reduced service | $281.84 | $354.81 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $141.25 Typical High $181.97 | Professional | 53 · Discontinued | $112.20 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $537.03 Typical High $676.08 | Professional | 54 · Surgery only | $426.58 | $537.03 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $107.15 Typical High $134.90 | Professional | 55 · Aftercare only | $85.11 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $70.79 Typical High $91.20 | Professional | 56 · Pre-op care only | $56.23 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $501.19 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $398.11 | $501.19 | $630.96 |
Where South Dakota sits
The same service costs 3.1 times more in Alaska than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
AK $5,990MD $1,938
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.